MEDICARE: RESTORATIVE CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251G0304X	Geriatric Physical Therapist		FL
2	225100000X	Physical Therapist		FL

General Provider Information

NPI Number	:	1245657576
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESTORATIVE CARE INC.

Provider Business Mailing Address
First Line	:	4121 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-2469
Country	:	US
Telephone Number	:	352-340-5924
Fax Number	:	352-340-5926

Provider Business Practice Location Address
First Line	:	4121 MARINER BLVD
Second Line	:
City	:	SPRING HILL
State	:	FL
Zip	:	34609-2469
Country	:	US
Telephone Number	:	352-340-5924
Fax Number	:	352-340-5926

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES HALLATT
Credential	:	DPT
Telephone Number	:	352-340-5924

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	10/13/2014

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Directions to “RESTORATIVE CARE INC. ” Practice Location

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